Hemoperitoneum secondary to spontaneous rupture of metastatic epidermoid carcinoma of liver: case report and review of the literature.

Massive hemoperitoneum due to spontaneous rupture of liver metastasis is remarkably rare. This is of interest because ruptured hepatocellular carcinoma is the most common cause of fatal hemoperitoneum in the Far East. We describe a case of hemoperitoneum secondary to spontaneous rupture of metastatic epidermoid carcinoma of liver. A 60-year-old man with chronic hepatitis C suffered from sudden onset of abdominal pain and pallid face with a tentative diagnosis of hepatocellular carcinoma with rupture. Tumor growth with rupture was suspected based on dynamic computed tomography, but the angiography could not demonstrate the tumor lesion. We diagnosed that the tumor was a metastatic epidermoid carcinoma, of unknown origin, based on the histopathological features. Therapy is palliative rather than curative, and the prognosis is very poor.